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Child Abuse
Types of Neglect
What is considered neglect is defined by the laws of each State. Physical, educational, and emotional neglect are the three major types of neglect.
Physical Neglect
The Department of Health and Human Services' Third National Incidence Study of Child Abuse and Neglect (NIS-3) defines physical neglect as any of the following:
- Refusal of health care—failure to provide or allow needed care in accordance with recommendations of a competent health-care professional for a physical injury, illness, medical condition, or impairment.
- Delay in health care—failure to seek timely and appropriate medical care for a serious health problem that any reasonable layperson would have recognized as needing professional medical attention.
- Abandonment—desertion of a child without arranging for reasonable care and supervision.
- Expulsion—other blatant refusals of custody, such as permanent or indefinite expulsion of a hild from the home without adequate arrangement for care by others or refusal to accept custody of a returned runaway.
- Inadequate supervision—leaving a child unsupervised or inadequately supervised for extended periods of time, or allowing the child to remain away from home overnight without knowing or attempting to determine the child's whereabouts.
- Other physical neglect—may include inadequate nutrition, clothing, or hygiene; conspicuous inattention to avoidable hazards in the home; and other forms of reckless disregard for the child's safety and welfare (e.g., driving with the child while intoxicated, leaving a young child unattended in a car).
Educational Neglect
The Department of Health and Human Services' Third National Incidence Study of Child Abuse and Neglect (NIS-3) defines educational neglect as any of the following:
- Permitted chronic truancy—habitual absenteeism from school averaging at least 5 days a month if the parent or guardian is informed of the problem and does not attempt to intervene.
- Failure to enroll or other truancy—failure to register or enroll a child of mandatory school age, causing the child to miss at least 1 month of school, or a pattern of keeping a school-aged child home without valid reasons.
- Inattention to special education need—refusal to allow or failure to obtain recommended remedial education services or neglect in obtaining or following through with treatment for a child's diagnosed learning disorder or other special education need without reasonable cause.
Emotional Neglect
The Department of Health and Human Services' Third National Incidence Study of Child Abuse and Neglect (NIS-3) defines emotional neglect as any of the following:
- Inadequate nurturing or affection—marked inattention to the child's needs for affection, emotional support, or attention.
- Chronic or extreme spouse abuse—exposure of the child to chronic or extreme spouse abuse or other domestic violence.
- Permitted drug or alcohol abuse—encouragement or permission of drug or alcohol use by the child.
- Permitted other maladaptive behavior—encouragement or permission of other maladaptive behavior (e.g., chronic delinquency, severe assault) under circumstances where the parent or caregiver has reason to be aware of the existence and seriousness of the problem but does not intervene.
- Refusal of psychological care—refusal to allow needed and available treatment for a child's emotional or behavioral impairment or problem in accordance with a competent professional recommendation.
- Delay in psychological care—failure to seek or provide needed treatment for a child's emotional or behavioral impairment or problem that any reasonable layperson would have recognized as needing professional psychological attention (e.g., suicide attempt).
Sexual Abuse
Child sexual abuse generally refers to sexual acts, sexually motivated behaviors, or sexual exploitation involving children. Child sexual abuse includes a wide range of behaviors, such as:
- Oral, anal, or genital penile penetration
- Anal or genital digital or other penetration
- Genital contact with no intrusion
- Fondling of a child's breasts or buttocks
- Indecent exposure
- Inadequate or inappropriate supervision of a child's voluntary sexual activities
- Use of a child in prostitution, pornography, Internet crimes, or other sexually exploitative activities
Sexual abuse includes both touching offenses (fondling or sexual intercourse) and nontouching offenses (exposing a child to pornographic materials) and can involve varying degrees of violence and emotional trauma. The most commonly reported cases involve incest, or sexual abuse occurring among family members, including those in biological families, adoptive families, and stepfamilies. Incest most often occurs within a father-daughter relationship; however, mother-son, father-son, and sibling-sibling incest also occurs. Sexual abuse is also sometimes committed by other relatives or caretakers.
Signs of Sexual Abuse
The presence of a single sign does not prove child abuse is occurring in a family; however, when these signs appear repeatedly or in combination you should take a closer look at the situation and consider the possibility of child abuse.
Consider the possibility of sexual abuse when the child:
- Has difficulty walking or sitting
- Suddenly refuses to change for gym or to participate in physical activities
- Reports nightmares or bedwetting
- Experiences a sudden change in appetite
- Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior
- Becomes pregnant or contracts a venereal disease, particularly if under age 14
- Runs away
- Reports sexual abuse by a parent or another adult caregiver
Consider the possibility of sexual abuse when the parent or other adult caregiver:
- Is unduly protective of the child or severely limits the child's contact with other children, especially of the opposite sex
- Is secretive and isolated
- Is jealous or controlling with family members
Physical Abuse
Generally, physical abuse is characterized by physical injury, such as bruises and fractures that result from:
- Punching
- Beating
- Kicking
- Biting
- Shaking
- Throwing
- Stabbing
- Choking
- Hitting with a hand, stick, strap, or other object
- Burning
Although an injury resulting from physical abuse is not accidental, the parent or caregiver may not have intended to hurt the child. The injury may have resulted from severe discipline, including injurious spanking, or physical punishment that is inappropriate to the child's age or condition. The injury may be the result of a single episode or repeated episodes and can range in severity from minor marks and bruising to death.
As Howard Dubowitz, a leading researcher in the field explains: "While cultural practices are generally respected, if the injury or harm is significant, professionals typically work with parents to discourage harmful behavior and suggest preferable alternatives."
Signs of Physical Abuse
The presence of a single sign does not prove child abuse is occurring in a family; however, when these signs appear repeatedly or in combination you should take a closer look at the situation and consider the possibility of child abuse.
Consider the possibility of physical abuse when the child:
- Has unexplained burns, bites, bruises, broken bones, or black eyes
- Has fading bruises or other marks noticeable after an absence from school
- Seems frightened of the parents and protests or cries when it is time to go home
- Shrinks at the approach of adults
- Reports injury by a parent or another adult caregiver
Consider the possibility of physical abuse when the parent or other adult caregiver:
- Offers conflicting, unconvincing, or no explanation for the child's injury
- Describes the child as "evil," or in some other very negative way
- Uses harsh physical discipline with the child
- Has a history of abuse as a child
Emotional Abuse
Psychological maltreatment, also known as emotional abuse, refers to "a repeated pattern of caregiver behavior or extreme incident(s) that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another's needs."
- Spurning (e.g., belittling, hostile rejecting, ridiculing)
- Terrorizing (e.g., threatening violence against a child, placing a child in a recognizably dangerous situation)
- Isolating (e.g., confining the child, placing unreasonable limitations on the child's freedom of movement, restricting the child from social interactions)
- Exploiting or corrupting (e.g., modeling antisocial behavior such as criminal activities, encouraging prostitution, permitting substance abuse)
- Denying emotional responsiveness (e.g., ignoring the child's attempts to interact, failing to express affection)
- Mental health, medical, and educational neglect (e.g., refusing to allow or failing to provide treatment for serious mental health or medical problems, ignoring the need for services for serious educational needs)
Signs of Emotional Abuse
The presence of a single sign does not prove child abuse is occurring in a family; however, when these signs appear repeatedly or in combination you should take a closer look at the situation and consider the possibility of child abuse.
Consider the possibility of emotional maltreatment when the child:
- Shows extremes in behavior, such as overly compliant or demanding behavior, extreme passivity, or aggression
- Is either inappropriately adult (parenting other children, for example) or inappropriately infantile (frequently rocking or head-banging, for example)
- Is delayed in physical or emotional development
- Has attempted suicide
- Reports a lack of attachment to the parent
Consider the possibility of emotional maltreatment when the parent or other adult caregiver:
- Constantly blames, belittles, or berates the child
- Is unconcerned about the child and refuses to consider offers of help for the child's problems
- Overtly rejects the child
Recognizing Child Abuse
The following signs may signal the presence of child abuse or neglect.
The Child:
- Shows sudden changes in behavior or school performance.
- Has not received help for physical or medical problems brought to the parents' attention.
- Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes.
- Is always watchful, as though preparing for something bad to happen.
- Lacks adult supervision.
- Is overly compliant, passive, or withdrawn.
- Comes to school or other activities early, stays late, and does not want to go home.
The Parent:
- Shows little concern for the child.
- Denies the existence of—or blames the child for—the child's problems in school or at home.
- Asks teachers or other caretakers to use harsh physical discipline if the child misbehaves.
- Sees the child as entirely bad, worthless, or burdensome.
- Demands a level of physical or academic performance the child cannot achieve.
- Looks primarily to the child for care, attention, and satisfaction of emotional needs.
